Ianiotescu Stelian, Gingu Constantin, Iordache Alexandru, Preda Adrian, Salloum Osama, Balescu Irina, Bacalbasa Nicolae, Sinescu Ioanel
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Center of Uronephrology and Kidney Transplantation, Fundeni Clinical Institute, Bucharest, Romania.
J Med Life. 2025 Apr;18(4):270-276. doi: 10.25122/jml-2025-0066.
This review consolidates recent evidence on managing renal cell carcinoma (RCC) in patients with solitary kidneys. It provides a comprehensive discussion of evolving strategies in partial nephrectomy-including open, laparoscopic, and particularly robot-assisted partial nephrectomy (RAPN)-along with thermal and advanced ablative therapies, non-surgical options (such as stereotactic ablative body radiotherapy [SABR] and active surveillance [AS]), and emerging neoadjuvant systemic treatments with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs). In addition, the integration of artificial intelligence (AI) for preoperative planning, intraoperative guidance, and postoperative outcome prediction is discussed. Given the limited renal reserve in these patients, preserving functional renal parenchyma is paramount. This multidisciplinary review synthesizes evidence from 2018 to the present and is supported by 70 contemporary references.
本综述汇总了近期关于单肾患者肾细胞癌（RCC）管理的证据。它全面讨论了部分肾切除术不断发展的策略，包括开放手术、腹腔镜手术，特别是机器人辅助部分肾切除术（RAPN），以及热消融和先进的消融治疗、非手术选择（如立体定向体部放射治疗[SABR]和主动监测[AS]），以及新兴的酪氨酸激酶抑制剂（TKIs）和免疫检查点抑制剂（ICIs）新辅助全身治疗。此外，还讨论了人工智能（AI）在术前规划、术中指导和术后结果预测中的应用。鉴于这些患者的肾储备有限，保留功能性肾实质至关重要。这篇多学科综述综合了2018年至今的证据，并得到了70篇当代参考文献的支持。
